Taniora Tauariki's 'Let's Make A Change' becomes Te Ara Oranga's theme song - Quarter 2/2017
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Quarter 2/2017
NORTHLA ND DIS TRICT HE A LT H B O A RD S TA F F MA G A Z I NE
Taniora Tauariki's 'Let's Make A Change'
becomes Te Ara Oranga's theme song.
Page 3
From the Chief Executive
Hi Everyone, discretionary effort, dedication and innovation to achieve
We've just won the America's what we did.
cup! Addictive wasn't it - like The innovation that led to Team NZ having such a great
many of you, I was adamant I boat with cyclists on board, use of hand held gadgets to
wouldn't get sucked in, and then control the foils and trim of the sails etc. would not have
end up being disappointed. come from Grant Dalton and his executive team - it would
However, always the optimist, have come from the sailors, designers, the people who
I began believing we would win know best what the problems are and how to fix them.
it, despite what happened last This is something we must get better at. Your leadership
time. Fortunately, the fastest teams can help, by agreeing a common purpose, provide
boat and the best team won, resources, training and support, unblock and improve
and NZ had both of them. processes where necessary, but after that it's up to all
Drawing on the America's cup analogy, there is a lot we of you to get better, continually improving, making fine
can learn, and a lot of similarities with where we need and sometimes not so fine adjustments to the way we
to be. do things. Please keep making these improvements - it's
exciting to see how we are doing in so many areas of
Being optimistic and proud of your team and Northland patient safety with improvements in falls, venous thrombo-
DHB - I know that the health sector is tough and we emboli, infection rates as well as a large number of other
never have enough resources, but we really are providing outcome measures.
some fantastic care, and I hope you can see that the
training opportunities and support that we try and provide We have some great teams and a culture of getting on and
all of you is improving too. Yesterday the Medical Council doing what needs to be done. However, unlike Team NZ,
completed a two day Accreditation visit, and they were we don't have the fastest boat. Our Whangarei Hospital
very impressed and we flew through all the standards we (Boat) is very old. We've got an old monohull and we need
were being measured on. They made it clear we were a catamaran that foils! Our people and what we all do is
among the very best DHBs with respect to all of these much more important than our buildings, but unfortunately
standards. The staff survey has shown areas where these buildings have got to the point where they are
we can get much better, particularly our focus on your holding us back and costing us time and money, and will
wellbeing, but on the other hand the large majority of you have an adverse impact on both you and our patients. We
are proud to work here, and are not considering leaving! will all need to be working in different ways as technology
and information advance and we continue to try and shift
What else can we learn. My apologies for overdoing the the balance of care into the community. However, we still
analogy, but I do think it is worth pursuing: need a new boat! Recently we got the first stage of our
Having the best team. Teams achieve so much more Programme business case for a new hospital approved
than groups of individuals. Each member of the team by the Capital Investment Committee (Ministry of Health
was excellent at what they did. This is important, but what and Treasury). There are three more business cases
they do together is far more effective than anything that that need to be completed over the next couple of years,
could be achieved by a group of individuals. Another thing and then we hope to be able to commence what is likely
to note, was that although there were six people on the to be, many years of building. We also had approval to
boat, there were at least 100 people behind the scenes proceed much more quickly with a number of enabling
enabling them to do their stuff. projects which will include two new Operating Theatres
to stop us having to work on weekends and improve our
- The over 8000 Elective procedures that we do each
acute Theatre capacity, an Endoscopy suite in preparation
year don't just involve the Surgeons, Anaesthetists,
for the national Bowel Screening programme in 2019, a
Theatre and Ward Nurses and Healthcare Assistants,
Community Mental Health facility, and a Laboratory for
but also require Physios, Occupational Therapists, Social
Cardiac Catheterisation.
Workers, Audiologists, Pharmacists, Lab and Radiology
staff, Ward Clerks, Outpatient Staff, Booking Clerks, So, by the time we have successfully defended the next
Telephonists, Porters and many others, all working at America's Cup, Whangarei Hospital will be beginning to
the top of their game to ensure we get through the ever look very different from what it is today. What we all need
increasing workload. to do is ensure that all that investment and innovation and
change will help us get up on our foils, and stay there 100
- The mass gang shooting a few months ago not only
percent of the time!
required three Surgical teams, but also clerical staff,
Laboratory and Radiology staff, Duty Managers and Kind Regards,
many others working through the whole night, some of
them on double shifts and some not even on call. In this
case, where there was a crisis (similar to when Team NZ's
boat capsized in the semifinals!) - it required incredible
Cover photo: Kaumatua Ben Hita and Kuia Wikitoria Wright honour Taniora (Daniel) Tauariki.
2 People First
Overview
Northland DHB and NZ Police have been funded $3m to
deliver the Te Ara Oranga Methamphetamine Demand
Reduction strategy pilot. The funding was made available
under the Criminal Proceeds (Recovery) Act. Te Ara Oranga Kaumatua Ben Hita, Taniora Tauariki, Carly Matthews and Kuia Wikitoria Wright
is an integrated model of Police and Health activity to
Composer of 'Let's Make A Change' Taniora Tauariki,
reduce methamphetamine demand by enhancing treatment
was honoured by Te Hā Oranga and gifted a pounamu
services and increasing our responsiveness.
taonga. Northland DHB and NZ Police have licenced
There are four workstreams within the health component Let's Make A Change as the theme song for Te Ara
- Screening, Brief Intervention and Referrer to Treatment, Oranga.
Treatment Whānau/Community Resources and Evaluation.
Governance These Hui facilitated by Pam Armstrong were well attended
Te Ara Oranga is governed by throughout the Rohe.
Executive Sponsors Dr Nick A community reference group was established following the
Chamberlain and NZ Police Assistant Hui and are being consulted throughout the development
Commissioner Richard Chambers of the whānau resources. Consumer representatives are
who is represented by Superintendent members of the Screening, Brief Intervention and Referrer
Commander Russell Le Prou. to Treatment (SBIRT) project team.
Dr Chamberlain and Superintendent Te Ara Orang kaupapa has strengthened relationships with
Dr Nick Chamberlain Russell Le Prou used to co-chair the whānau, communities and service providers throughout
social wellbeing governance group, a Te Tai Tokerau. Te Ara Oranga is a joint initiative between
government social sector collaborative Northland District Health Board and New Zealand Police.
group that has responded to youth
'Let's Make A Change'
suicide and family harm.
Te Hā Oranga has been instrumental in the creation of
The Project Board is co-chaired by
Let's Make A Change / He Waka Eke Noa, a CD written
Northland DHB Mental Health &
and performed by clients, staff and supporters of alcohol
Addiction Services General Manager
and addictions programme He Timatanga Hou (New
Ian McKenzie. Before the project
Beginnings).
Supt. Russell Le Prou began Mental Health & Addiction
leaders met with the Kaunihera The CD is dedicated to the memory of Matua Rob, Te Hā
Kaumātua (led by Kaumātua Rob Sarich who sadly passed Oranga's kaumātua 1996-2017. Let's Make A Change is
away recently) to explain the vision of the project. featured on the Te Ara Oranga social media video clips and is
being produced as a community music video demonstrating
This meeting set the platform for the project. The Kaunihera
community action against methamphetamine.
Kaumātua provided encouragement, support and the
mandate for the work. They suggested Hui be held in the Copies of the CD can be brought from Te Hā Oranga -
community as an opportunity for whānau to have a voice. 0800 698342.
Wāhine Toa - There are key Wāhine who have helped move this kaupapa forward and make it a reality.
Jenny Freedman, as clinical Segina Te Ahuahu contributes
champion for Te Ara Oranga many years’ experience of delivering
and the Addictions Professional Kaupapa based services in Te Tai
Advisor, is absolutely committed Tokerau. Segina also champions the
to strengthening evidence based collaborative contracting methodology
addiction services as the next that endeavours to achieve a
step in providing treatment for the collaborative sector approach.
northland populations.
Jewel Reti, Project Manager, Pam Armstrong has been an Alcohol
is responsible for weaving the & Addiction health practitioner for
work strands together to create, 20 years and is passionate about
build, strengthen and unite Te Ara enabling communities to engage and
Oranga. work cooperatively.
These leaders represent more than seven decades of expertise and commitment in addiction treatment in Te Tai Tokerau.
Respect 3
Clair Mills Moves on to MSF
Northland DHB huge health inequalities in terms of life expectancy and
Medical Officer of maternal mortality.”
Health Dr Clair Mills
Life or death hazards for MSF workers are very real. “You
has left Whangarei
try not to put your life at risk; if you’re working in a conflict
once again to work
zone MSF has robust security management, but the risk
for Médecins Sans
is never zero. In Sri Lanka there was a lot of shelling, a
Frontières (Doctors
lot of helicopter bombing, whereas in South Sudan it was
Without Borders –
more of a risk of a drunk 14-year-old with a gun stopping
MSF).
your car. That’s easier because at least you can talk to
Clair is taking on the
them. You end up doing a lot of negotiation and talking
esteemed position
to provide healthcare access.”
of Medical Director
at the organisation’s Public health crises including HIV/AIDS, Ebola,
Paris headquarters, tuberculosis and rape have been recurring missions
overseeing medical in Clair’s work. Clair said one of MSF’s main ‘pillars’
departments in France, is the mission to witness atrocities and epidemics so
New York, Sydney and Japan. MSF works in nearly 70 that awareness and advocacy can result. MSF values
of the world’s most war-torn and deprived countries and international staff highly “because we can be outspoken
has 36,000 personnel, most of who are volunteers. The more than national staff who are under difficult regimes.”
organisation is wholly independent and funded by private Rape by soldiers was an issue Clair had to deal with when
individual donations from across the globe. working in eastern Congo, which has been occupied by
Ugandan and Zimbabwean troops who have spread HIV
Clair’s send-off in late April was a powerful occasion
through unprotected sex. “We talked to the military about
with waiata and speeches honouring not just Clair’s
risks; I brought in a planeload of condoms – they called
commitment to the community, but also emphasising the
me the Condom Queen for a while! I landed in Goma
values of Clair’s whānau who have a culture of strength
with boxes and boxes of condoms – security troops were
and advocacy. One speaker described the Mills sisters
very excited.”
as “warriors of peace and justice.” “She’s not interested
in doing what’s popular,” said another speaker, “She’s Perspectives on New Zealand
interested in doing the right thing”. Marion Bartrum praised
“In our last report to the government, we reported that
Clair’s “unwavering commitment to reducing inequities”.
health inequalities are increasing. We can’t afford not to
In particular, Clair is known for her work around the sale
be doing more about smoking and obesity.”
and supply of liquor, as well as tackling rheumatic fever
rates in Northland. Clair, who learned French and some Te Reo Māori when
she was at school, said it is a responsibility for staff in
Clair’s remarkable career
Northland DHB to try to pronounce Te Reo Māori properly
Born and raised in Whangarei, Clair became Medical and if possible practice using the language. “Language
Officer of Health in 2011. After medical training, Clair is a pathway – it helps you understand how people think.
returned to Whangarei as a house surgeon and did her There’s appreciation from patients that you’ve made an
GP training in Northland. At 30, Clair then joined MSF and effort.” Having been exposed to dozens of conflicts, Clair
went to work in South Sudan in 1993, when the country said New Zealand is lucky that the Land Wars of the
was embroiled in a civil war spanning three decades. Clair 1860s didn’t lead to ongoing civil conflict here.
also worked in the conflict-riven countries of Rwanda,
“We forget that once conflict starts it builds a terrible cycle
Congo and Sri Lanka. Clair completed her Masters in
that feeds on itself. Imagine it: if your family has been
Public Health in London in 1996/7, spent a year working for
killed, why would you hope for a democratic future? That’s
the World Health Organization then three years with Save
an understandable emotion. For countries coming out of
the Children in Congo and Mozambique. She returned to
conflict, how do you build a future that recognises the
New Zealand for public health medicine specialist training
harm and suffering and trauma, yet can build something
2001–2004, after which she was National Immunisation
secure?”
Manager at the Ministry of Health. Following that, Clair
was called back to MSF where she spent nearly five years Clair left Northland DHB on 20 April after being farewelled
as Medical Director in Amsterdam. by a broad range of healthcare colleagues, including
Northland DHB and Manaia Health PHO.
Two things keep calling Clair back to MSF – initially it
was the sense of adventure, Clair said, but also the One of Clair’s immediate challenges will be finding a place
way medicine enabled her to work anywhere. “Some to live in Paris, where small apartments are the norm
people use their training to go to the United States and for most people. “I’ve been offered one that’s 33 square
become brain surgeons. But that’s not for me. MSF is metres,” Clair said, “It will be a bit different from my 70
very interesting work, that’s the primary thing, and it’s acres of bush at Matapouri!”
a bit addictive. […] The reason MSF exists is there are
4 Caring
All the Best as Bartrums Retire
Marion and Sam Bartrum retired from Northland DHB
on 25–26 May with farewell celebrations for Marion
and Sam on 19 and 26 May, respectively.
Marion has been service manager for the Public and
Population Health Team as part of Child Youth and Maternal
Health. Sam was the general manager for Planning,
Outcomes, Integrated Care and District Hospitals. The
two have spent most of their careers in health, but from
very different backgrounds and departments.
Marion – who was born at Whangarei Hospital – began
as a registered general nurse at Middlemore Hospital
after graduating in 1978. She was then a Plunket nurse
in Mangere before moving to Northland DHB in 1985 as
programme up and running and worked on the ‘Only pigs
a public health nurse. Marion has been in her combined
look good in pink’ campaign in collaboration with Cancer
roles for 32 years.
Society in Whangarei and Auckland as well as working
Sam, born in Mangakino, came to Northland DHB for his with Northport.
most recent position after 13 years as Director of Human
Marion also worked on one of the first public-private
Resources at Waitemata and Counties Manukau DHBs.
enterprises, in which Fulton Hogan stop/go traffic
Before this he was GM of Public, Community and Mental
operators spread messages about Northland’s high UV
Health at Hutt Valley DHB and, before that, GM of Human
light problems and handed out info and sunscreen. She
Resources at Northland DHB. Sam has also been GM of
worked with boaties on a similar campaign and even
Community Health at Northland DHB.
took the SunSmart vehicle with a pig on top down to the
Sam’s involvement in public health began in the late Auckland Santa Parade (the pig today has a new home at
1980s as a health worker organiser for the Public Service Whangarei’s Piggery bookshop.) After SunSmart, Marion
Association. In his time, Sam has been involved in the took on the coordination of Community Injury Prevention
building of gymnasiums at three DHBs but no hospitals Programmes and was proud to help Whangarei become
until the recent rebuild of Bay of Islands Hospital. accredited in 2006 as one of the NZ Safe Communities,
Sam said he expects the new integrated Te Hauora O which is endorsed by the World Health Organization.
Pukepuke Rau hospital/clinic/A&E at Kawakawa will be
Retirement perspective on Northland
truly significant for the people of the mid-north. “Dargaville
and Kaitaia hospitals are lovely and well-kept and it’s time Although they plan to enjoy the exotic beauty of the Gold
Bay of Islands got the healthcare facility it deserves,” Coast, and later the Mediterranean, Sam and Marion
Sam said. describe their home region as a paradise where anyone
who enjoys the water can make the most of swimming,
Marion and Sam, now living just outside of Whangarei
diving, yachting, fishing and boating. “Northland is one of
at Waikaraka, have known one another since the 1970s,
the best places in the world to live,” Sam said.
been a couple for well over 20 years and were married
nine years ago by (at the time) Manaia Health PHO chief Still, both acknowledge the challenges Northlanders face
executive Chris Farrelly, a family friend and wedding as our DHB slowly but surely reduces the life expectancy
celebrant. gap between Māori and non-Māori. Marion said her team
works extremely hard to reduce inequities and one key
Marion and Sam have plenty of family to keep them
highlight has been Northland DHB nearly eradicating
company, with six children between them sprinkled across
incidences of rheumatic fever during her tenure.
the country. After their kids grew up, Sam had more
flexibility to travel long distances to work, commuting all Marion added she will be pleased to see Fit For Life and
the way to Auckland when he was at Counties Manukau Food Rescue supporting population health initiatives to
and Waitemata DHBs. “I would leave from Whangarei succeed. Those programmes should challenge the well-
4.30 on Monday mornings, come home Friday evenings,” resourced takeaway, alcohol and tobacco industries.
Sam said. Marion acknowledged Jamie Leaf’s management of those
programmes.
Decades dedicated to improving community
conditions Sam said he is looking forward to days without email and
some uninterrupted fishing. Retirement may include a
Looking back at her career, Marion is proud of the
cruise and biking the Otago Rail Trail, maybe on e-bikes.
contribution she made as a public health nurse and
eventual leader of the public health team. Specific projects First things first, though: “The Monday after we finish
she’s proud to have worked on include asthma education, we’re going to jump on a plane to the Gold Coast,” Marion
World Health Organization Safe Communities and said. “We’ll sit on the beach, reflect, start a plan and
especially SunSmart. Marion helped get the SunSmart maybe have a few glasses of bubbly!”
Communication 5
Parenting Service Launched for
Mental Health and Addictions Clients
Whangarei MP Dr Shane Reti addresses the audience at the launch of He Tupua Waiora
A new service to help clients of Mental Health and Addictions He Tupua Waiora was launched at Tohorā House,
Services (MHAS) was launched at Whangarei Hospital on Whangarei Hospital, where He Roopu Kimiora Service
March 20. Known as He Tupua Waiora Pregnancy and Manager Agnes Daniels spoke about her years of
Parenting Service, the new approach is possible thanks experience working alongside at-risk mums. “Change
to $1m in funding for each of the next four years and will has to come from within [clients],” Agnes said, adding that
reach 100 pregnant women and parents of young children the new service aims “To touch people in their hearts.”
every year. He Tupua Waiora is aimed at preventing and Agnes said the service represents Northland DHB’s official
reducing harm to children under three years old. It is based values. “Tumanako (hope) is the best value in this service.
on a model of care developed by Waitemata DHB. DHBs in Because it’s hard for children to act for themselves, it’s our
Tairawhiti and Hawkes Bay are providing a similar service responsibility to work alongside the parents.”
to that launched in Northland. Its main work will be carried
At the launch, Agnes emphasised to Richard Taylor of
out in the Whangarei hub, with a ‘spoke’ of the hub located
the Ministry of Health her gratitude for the funding for the
in Kaitaia.
service. She then welcomed Whangarei MP Dr Shane Reti
He Tupua Waiora will provide its service in a flexible, non- and recalled what it’s like to be a patient with a baby, taking
judgemental, client-focused way, supporting whānau self- hers to see Dr Reti in his role as a GP in the early 1990s.
efficacy, empowerment and recovery, and will practice
Agnes said patients trusting their health practitioner
from a social justice perspective. It was brought about
enough to go out of their way to see that person is the
because Northland DHB could see more help was needed
sort of service everybody wants. “Shane started a clinic
for mothers and mothers-to-be who have multiple complex
on our marae at Pipiwai. He didn’t pass judgement on our
and interacting issues including dependence disorders,
people. Shane was with us providing health services for
cognitive impairment, histories involving neglect, abuse
16 years – he’s the reason we have salad at every kai!”
and domestic violence, multi-generational dysfunctional
Dr Reti wished the programme success on behalf of the
family patterns and involvement with child protection
Government. Marijke Cederman and Robert Steenhuisen
agencies and the justice system. The service primarily
of Waitemata DHB were thanked with a gift for their
aims for reduced substance abuse in mothers as well as
contribution to He Tupua Waiora. Stakeholders in the
safety and an enhanced psychosocial environment for
service will include PHOs, Salvation Army and Northland
infants, reduced family violence, improved housing and
DHB’s Child Protection Coordinator; and of course parents,
reduced offending.
whānau and caregivers.
Shelley’s story at service launch
An important voice at the launch came from patient Shelley, who has at times been a client of MHAS. A speech
prepared by Shelley was read which spoke of her gratitude for caring health services which helped her through her
most vulnerable times. Diagnosed with depression, post-natal depression, anxiety, post-traumatic disorder and with
a history of family violence, Shelley had high-risk experiences during pregnancy including attempted suicides and
substance use. Shelley’s relationship with maternal and infant mental health services in Kaitaia began in 2014. Since
that time Shelley has had an ongoing relationship with staff whom she says have gone over and above to ensure
that she stays well. “During pregnancy I become very mentally unwell, irrationally suicidal, and as a result there was
a point when my children were removed from my care. My health worker would come at any time of the day or night,
travel to Whangarei to attend appointments with me and eventually after recovering from mental illness and drug
abuse (as a result of taking prescription medication for a back injury) my children were returned to me.”
6 Excellence
April Falls: A Month of
Patient Safety Awareness
The aim for the newly formed Vulnerable Patient Group
(formerly the Falls & Pressure injury group) has been
to ensure patients have safe mobility plans, decluttered
environments and regular toileting. The group is a
multidisciplinary group and as Professor Anne-Marie Hill
said at a recent Falls Prevention seminar, physiotherapists
play a pivotal role in falls prevention.
Some of the awareness campaigns and activity around
April Falls month included:
• An April Falls screen saver campaign
• Ward maps identifying spots where injuries are likely
to result
• Therapy dogs Jo and Sam wearing non-slip socks as
Left to Right - Bronwyn Morgan with Sheryll Beveridge
a talking point for patients around falls awareness.
Every April the Health Quality & Safety Commission’s
(HQSC) April Falls promotion raises awareness of the
importance of reducing falls with harm in hospitals. This
year the falls prevention message went out into the
community. HQSC and Northland DHB Health of the
Older Person team continue to work collaboratively with
ACC on a project to prevent falls and keep people out
of hospital.
In April the inpatient wards were given a falls cross chart
to help staff, patients and their whānau visualise how
many falls are occurring. The wards were encouraged
to add a map of the ward to identify where the falls were
occurring. This enabled the teams to analyse where the
trends were in their wards and how to reduce the risk of
patients falling.
The individual needs of patients and responses to those
patients are different. For example, some patients are
assessed for the need for non-slip red socks to keep them
from slipping, while patients in ward 15 wear orange wrist
bands so nurses know the patient is high risk of falling if
they try to mobilise without assistance.
People First 7
Te Tai Tokerau Nursing
and Midwifery Awards
Nurses and midwives make up the largest component of our health workforce in Northland. We honoured them with
the Te Tai Tokerau Nursing and Midwifery Awards 2017 at Tohorā House on May 11. Midwife Sue Bree was the guest
speaker. The award winners were:
Nga manukura – Effective nursing leadership Te mana whakahaere – Consistency
Joint Merit: Winner: With Merit: Winner:
Rachel Thompson Helen Topia Sam Wall Hayley Moyle
Keryn Thornton Clinical nurse Nurse practitioner/lecturer Clinical nurse manager, District
manager (pictured) Nursing, Whangarei
Mauri Ora: – Nursing Workforce Toiora – Education
With Merit: Winner: Joint Merit: Brydy Wilson Winner:
Raiquel Te Puni Candy Cassidy, DAO Ngati Hine Nursing Team Davina Mannion
(Koha Aperahama, Sharon Clinical nurse educator, ICU
Henare & Tracey Wihongi)
Waiora – Excellence in Clinical Practice Te Oranga – Innovative Models of Care award
With Merit: Winner: Joint Merit: Winner:
Alison Carlin Oringa Barach Christine Baucke Te Hau Awhiowhio o
CNS, Diabetes Fiona Bamforth (pictured) Otangarei Nursing Team
Women & Newborns – The heart of midwifery
(L) Winner: Maryanne Kaye Midwife
(R) Merit: Samantha Harris Team Leader, Te Puawai Ora Maternity service
Alma Ringrose (pictured with her family and Mary Carthew)
received a special long service recognition award from Manaia Health PHO.
8 Respect
Alison Carlin
Alison Carlin’s decades of work in gynaecology were
recently recognised with the presentation of an NZ
Gynaecological Foundation Award in recognition of the
“outstanding, above and beyond” work Ali has done in her
role as a clinical nurse specialist.
Ali became a registered nurse in 1981, completed
midwifery in 1983, came to NZ as a midwife for a one-
year working holiday in 1986, stayed on and became a
Clinical Nurse Specialist in 2010. Today Ali is on a clinical
governance group for cervical screening, and the Northern
Regional and NZ Gynaecological Cancer Groups.
Acknowledging nurses who have passed away
Left to Right - Yvonne Morgan, Sam Harris, Deb Pittman, Joy Leslie, Three of our valued nurses passed away over the last
Maryanne Kaye, Sue Bree
year. Tributes to these women, describing their careers
Acknowledging nurses’ achievements: and how fondly they are remembered, were read. We
Crete Cherrington acknowledge:
After delivering an estimated 1500 babies in her career Marion McAulay (passed away 15 October 2016), Jean
to date Crete Cherrington was appointed kuia of the New Partridge (passed away 25 February 2017), Lynette
Zealand College of Midwives in March 2017. Collins (passed away 1 May 2017).
Moe mai e te tuahine, moe mai, moe mai.
Acknowledging Nurse Nightingale’s legacy of hygiene
By Mo White - Infection Prevention and Control Clinical Nightingale would have been impressed at the mountains of
Nurse Specialist documentation as by 2008 Infection Prevention and Control
If you visited any hospital or clinic in New Zealand Standards became part of the Health and Disability Services
on International Nurses Day, you can thank Florence Standards.
Nightingale for keeping the facility as clean as possible. In Northland today, we carry out the legacy of the Lady with
160 years ago birthday girl Florence observed the need the Lamp by providing each patient with entire services
for professional nursing standards and uniformity, enacted dedicated to clean beds and linen, the cleaning, sterilisation
those standards and contributed to scientific advances in and supply of sterile equipment, plumbing, sanitation and
understanding pathology. waste workers. We monitor multidrug-resistant bacteria,
Nurses are the largest profession in Northland’s health bloodstream infections and surgical site infection. Our
system and make a distinct difference in the health outcome Infection Prevention and Control (IP&C) team are trained
of every patient, which is why we honoured with them with hand hygiene auditors and trainers. The Health Quality
the Te Tai Tokerau Nursing and Midwifery Awards. Safety Commission’s hand hygiene compliance target is
80 percent, but thanks to Northland’s IP&C team, we have
Without infection control specialists and nurses safeguarding a hand hygiene compliance rate of 88 percent. IP&Cs are
each patient, we would be overwhelmed by infection even involved in the planning, design and construction of
complicating each patient’s recovery. Perhaps the worst- healthcare facilities. This stems from Florence Nightingale’s
ever sanitary levels for patients in recent history were discoveries about how fresh air, isolation and room layout
the conditions found in the squalor of the 1850s Crimean affect patient health.
War, with its dreadful hospitals and barracks. It was those
conditions that inspired Florence in her work, leading to Everything Florence accomplished helped create better
generalised nursing which in turn led to the specialised patient outcomes. She set a standard which every day we
nursing roles which make such a difference today. try to match.
The role of Infection Control Nurse, established in New
Zealand in the 1980s, was primarily to identify the number
of patients who developed infections after their admission
to hospital. Hospital-wide surveillance enabled patients with
infections to be isolated from others. It did little, however, to
address the cause of the infection. Eventually the first New
Zealand Standards for Infection Control were established
in 2000. These provided a guide for infection control
programmes in all hospitals and healthcare facilities.
In 2003 the Auditor General reported on a nationwide survey
to discover how hospital acquired infections were being
monitored, and by whom. Accreditation surveys, certification
surveys and mandatory standards followed. Florence Left to Right - Mo White, Sandra Cunningham and Premila Reddy
Caring 9
Relay for Life Walking and running through the night helped a Northland DHB team raise over $1700 towards the Cancer Society’s Relay For Life event on April 1-2 in Whangarei. The Whangarei event alone featured 650 competitors from 46 teams and raised just under $100,000 for the Cancer Society as participants walked, ran or jogged around Whangarei's Trigg Stadium. Nationwide, Relays For Life raised over $1.27m thanks to 704 teams and 6157 participants. Tina Vink, organiser of the Thongaray Friends team, got together a team of 11 who ran, walked, and shuffled through the night before being rewarded with a big cooked breakfast on Sunday morning put on by New World Regent. The team’s quirky name came about because “Northlanders are renowned for walking in bare feet and wearing jandals,” organiser Tina Vink explained. Before the event, the Thongaray Friends raised money through their entry fee and by collecting donations on the Relay For Life website. The team also decorated a Christmas tree with children’s jandals, sold the jandals for a koha and donated the money to Cancer Society. On top of this, staff at Whangarei Hospital’s Tohorā house donated Eco products, healthy foods and a treat of Easter chocolate contributing to five raffle baskets. 10 Communication
Excellence 11
How We Meet the Needs of
Northland’s Ageing Population
By Anu Ragnat, Clinical • Home visits and assessments for cognitively impaired
Nurse Specialist older people who have been referred directly to me
– Gerontology by different health professionals in the DHB or from
community organisations like Alzheimer’s Society.
Starting in my gerontology
CNS role in the Health • Working closely with Needs Assessment team (NASC),
of Older People team at post discharge coordinators, social workers, GPs,
Whangarei Hospital in community assessment and rehabilitation (CARS) team
August 2015 introduced me etc to help older people to access the support they need.
to a group of exceptionally
• Providing education for patients and carers, especially
passionate knowledgeable
about cognitive impairment pathway and management
senior nurses who provide
of dementia and related issues.
care for the older population
of Northland. I want to emphasise the importance of raising awareness
about the support options available for our older population in
The Health of Older People
the community and directing them towards the teams under
(HOP) and Clinical Support
HOP to access supports.
speciality Nurses Team,
located on Level 2 of If you’d like to know more about the services under Health
Maunu House, comprise of Older People please go to:
post-discharge coordinators, fracture liaison nurses, elder https://www.healthpoint.co.nz/older-peoples-health/northland/
clinic nurse, stroke CNSs, gerontology nurse specialists in
I can be contacted on 09 430 4101 ext 8014 for any queries.
Whangarei, BOI and Kaitaia and a practice development/
aged residential care coordinator under the strong leadership
of our clinical manager Josephine McCathie.
The world is going through a demographic revolution because
of its ageing population. Projections indicate that in New
Zealand between 2011 and 2021 the elderly population will
grow by 200,000 and by 2051, 1.14 million people will be in
this age group. This means one in every four New Zealanders
will be elderly by 2050. The 2013 Census indicated people
aged over 65 comprise 18 percent of Northland’s population.
As the population ages, age-related fragility and accumulating
multiple chronic conditions require care coordination which
often can span all healthcare settings. Northland’s population
is older than the national average, which causes more
demand on services. Dementia is one main example and
is a speciality I work closely with, which gives me immense
job satisfaction and fulfilment.
As our ageing population grows, there will also be an
increase in the number of people with dementia. In 2011, just
over 48,000 New Zealanders had dementia. This number is
estimated to reach 78,000+ by 2026, an increase of over 60
percent. There are strategic action plans in place to support
our Northland population and the specialised skills of the
HOP team are fundamental in making sure there is safety
in community settings.
My role includes:
• Clinical assessments for the clinically fragile/complex
elderly population who are waiting to be seen by
geriatricians, and navigating those people through the
cognitive impairment/dementia care pathway. They often
also need to be assessed about the safety concerns
around medication – polypharmacy and falls.
Anu visiting patient Colleen Cheak
12 People FirstNorthland Patients Part of
Worldwide Hep C Cure
Northland DHB physician Dr Kaye Logan and hepatitis
clinical nurse specialist Sandra Meyst said the release of
Viekira was “exciting” but also generated apprehension.
For now, Kaye and Sandra can only use Viekira Pak with
patients of Genotype 1, a genotype representing around 60
percent of patients.
Because of the origins of Hep C infection, including blood
exchange from intravenous drug needles or tattooing
equipment, many patients have experienced guilt, shame
or stigma around their condition, intensified by the low
success rate of the Interferon and Ribavirin antiviral treatment
options which were the norm until Viekira. These antivirals
were expensive and many side effects would sicken those
undergoing the treatment. “For so many years it’s been
Left to Right: Visiting hepatologist Dr Rachael Harry, CNS Sandra Meyst, Liver
depressing to treat, very intensive, often disappointing, with
Service RN Judy Coyne patients unwell and miserable,” Kaye said.
Northland is among the locations worldwide where a drug The cure rate brings great news to the patients born between
to treat Hepatitis C is achieving a near-100 percent success 1945 and 1965 most likely to suffer from Hepatitis C. “In
rate. Curing the disease in individuals is hoped to contribute my job often you don’t cure people,” Kaye said. “It’s nice to
to the worldwide eradication of the debilitating liver disease be able to cure something.” Those who have successfully
as an epidemic. taken the course of Viekira “have had a big emotional burden
Viekira Pak is a combination of four antiviral medicines lifted,” Sandra added.
which PHARMAC began publicly funding from July 2016. In The next step in eliminating Hepatitis C as a public health
Northland – where there are up to 500 people diagnosed with problem will be ensuring Viekira is safely prescribed and
Hepatitis C, and many more undiagnosed – 73 patients had dispensed and that GPs – who are able to treat patients
been successfully cured of Hep C as of the end February, without cirrhosis – understand safety around Viekira interacting
with only one known unsuccessful treatment. As at the end with other drugs. Other factors in the patient’s health will also
of March, 108 patients had been initiated on Viekira Pak. affect the success of Viekira.
Viekira and other antiviral drugs, combined with prevention For now, GPs are being educated about the funding available
programmes, are expected to eradicate the virus as a to get Hep C sufferers engaging with their clinic. “When the
public health problem by the year 2030, the World Health dust settles we will go out and reach people who don’t see
Organization says. 50,000 New Zealanders are estimated to their GP and aren’t treating their disease,” Kaye said. “We
carry the blood-borne virus, although only half that number want to hunt them down and give them treatment – in future
of people are currently diagnosed. Globally, WHO estimates we want to eradicate the disease, like with smallpox.”
up to 150 million people live with the disease.
A New Lease of Life: Martin’s Story
A Whangarei patient, who asked to be known as Martin, wept as felt good to share my story, it was an eye-opener to them. I had
he shared the story of Viekira curing him of a 20-year illness “equal felt like a burden on society. You couldn’t talk about it, it was not
to cancer”. Hep C had given Martin years of shame, discomfort, cool that I got my illness through perceived irresponsibility. No one
depression, and made him feel he was a burden on the healthcare wanted to know about it.”
system. Today, Martin says he has a “new lease of life”. “It was a debilitating disease, equal to cancer. You live with
Martin, now 62, contracted the virus as a university student four depression; you wake up feeling like you’ve got the flu and don’t
decades ago, but like many people he was only diagnosed in his know why. You just put up with it. It’s not something you share.
40s, after which cirrhosis began to set in. “When I heard Viekira People don’t appreciate what it does to you – it’s like running on
was coming I rang Nurse Sandra and got on the Viekira list. I’m half your cylinders. On top of my shitty liver I had unexplainable
so thankful. I feel like it’s given me another 30 years of life.” Martin grumpiness and moodiness and when I was stressed, the effects of
thanked Sandra and Kaye for their caring approach and said the Hep C hit me tenfold. I have lost a couple of mates to liver cancer.
work of award-winning Auckland City Hospital hepatologist Professor In the last 2–3 years I was getting pretty desperate; mild cirrhosis
Ed Gane and his team of specialists also helped Martin's recovery. was kicking in. In the back of my mind was finality.”
Part of Martin's journey involved giving an emotional speech to It was the new year when Martin received the good news: after
GPs and pharmacists as they were educated about the impact 12 weeks on Viekira Pak, blood tests proved he was now clear of
Viekira can make. “The speech was a pretty emotional time. I was Hepatitis C. “I’m not ashamed of what I did, how I got it, I was just
so thankful, and other patients were, to be given that chance. It fortunate to live through it.”
Respect 13Mario Added to Jim Carney
Portrait Series
Longview brand and its reputation. Longview Estate was
the place where Mario’s son Richard began learning
how to become an award-winning winemaker. Mario is
proud to have directed Longview Estate to its position
of business success today. While doing so he created
a wine called White Diamond which grew into a brand
popular enough to command well over $500 per bottle
in China.
The portrait affirms the role of winemaking in Vuletich
family values, and it was amongst the grapes that
Mate, Mario and Richard spent many years bonding.
From the age of three, Richard was carried around in
a baby carrier on Mario’s back while Mario worked in
the vineyard. As Richard grew bigger so did his passion
for wine, just like his father’s. After his graduation from
wine school, Richard became a valuable and successful
asset to the wine industry as a young, up and coming
winemaker, in a senior position at Moss Wood winery
near Margaret River, just south of Perth in Australia.
Mario's portrait in the Jim Carney Cancer Treatment Centre Mario says his son was 6 feet 2 inches tall, had blonde
hair and blue eyes, and an amazing personality. His
Mario Vuletich is the latest person to have
presence lit up any room that he entered, Mario said.
their portrait put on the walls of the Jim Carney “Losing my son broke my heart.”
Cancer Treatment Centre at Whangarei
Mario fought bowel cancer for many years, then
Hospital. melanoma “showed its ugly head”. After Richard passed
Mario, 65, says he has had a lifetime of battling bowel away, Mario and his family decided to sell Longview
cancer which stemmed from Lynch Syndrome, inherited Estate. The winery and vineyard was acquired by a
from Mario’s father’s side of the family. Mario has had group of New Zealand and Chinese investors in March
three family members pass away due to bowel or 2016. The investors valued the expertise of the Vuletich
pancreatic cancer, including his beloved son Richard family so much they retained Mario on the estate as
who passed away two years ago. head winemaker. The vineyard has now become a
place for Mario to mentor a young student winemaker,
Mario has an enthusiastic, passionate and positive
Tony. Mario continues to live at Longview Estate in the
personality for a man who has endured so many
family homestead with his 14-year-old family cat and
health complications. At one point he flew to Australia
is proud to have reached retirement age despite the
to purchase the cancer drug Keytruda and brought it
challenges of the cancer-causing Lynch Syndrome.
back to New Zealand where he underwent lifesaving
immunotherapy at Mercy Ascot Hospital in Epsom. “Two-and-a-half years ago I was given three months
When interviewed on a sunny morning at the Jim Carney to live,” Mario said. “Keytruda immunotherapy wasn’t
Treatment Centre, Mario couldn’t wait for his 30-minute subsidised in New Zealand at that stage, so I ended up
immunotherapy infusion to finish so he could get back spending $130,000 to retrieve six infusions of it from
amongst the grapes by lunchtime. Australia.” Mario says Keytruda shrunk his lymph node
tumours successfully. After two years there was some
Mario is passionate about White Diamond grapes and
recurrence, although now Keytruda is publicly funded
wine as well as the Gewürztraminer, syrah, Gumdigger’s
and Mario hopes the three-weekly Keytruda treatment
Port and dry reds Longview Estate is known for. The
at the Jim Carney Treatment Centre will suppress the
vineyard is also a sacred place for Mario’s family – it
melanoma and other types of cancer. “Keytruda is a
was where Mario worked with his mother and father
miracle drug,” Mario said, before returning to the subject
from when the business was established in 1969.
he is most passionate about: winemaking.
Mario’s parents came to New Zealand from Croatia,
Mario’s large photographic portrait, taken by Liz Inch,
which he describes as “a country with a strong culture
will sit alongside those of Sam Hart surfing and Marlene
where everybody grows their own grapes and makes
Tuhiwai gathering with whānau at her marae. All of the
their own wine”. Not long after completing his engineering
portraits have one thing in common: they portray people
apprenticeship, Mario’s dad Mate passed away due
enjoying life, with or without illness. Mario is portrayed
to pancreatic cancer, so Mario took his dad’s place at
at home on Longview Estate – where he has lived for
the age of 26 alongside his mother Milly in building the
50+ years – working on his beloved White Diamond.
14 CaringOur Staff Strike Gold at
World Masters Games
The World Masters Games, held in Auckland in late April, was the largest-ever athletics meet
in this country. 25,000 athletes were there from over 100 countries – and plenty of Northland
DHB staff were in the mix. Across the ten-day event, our Northland DHB whānau achieved
personal bests and a range of gold and silver medals. Across 28 sports and 45 disciplines,
our people brought home results including:
Northland DHB communications officer Paula Diabetes clinical nurse specialist Oringa Barach
Martin achieved four out of five personal best times. competed in the half marathon and came eighth in the
“The highlight for me was taking 13 seconds off my 200 70–74 age group, achieving a time of 3.18.10. If that
medley time, 4 seconds off my 100 m breaststroke and achievement wasn’t enough, Oringa participated in the
3 seconds off my 50 m butterfly,” Paula said. “All those triathlon as well, which involved a 750m swim, 20km
weekends staring at the black line on the bottom of the cycle and 5km run. “It was a pretty difficult event due
pool was worth it. I met some extremely talented and to the weather. The 65+ group were the last group to
committed athletes during the games, which put the head off. By this time, the sea was rough, the wind had
level of competition into perspective.” got up and it was pouring with rain, making life tricky!
The course was changed and the swim shortened,
Senior hand physiotherapist Jane Sweeney
there were no hills on the biking part, just three laps
competed in just two cycling events, and won gold
on the flat. I got hauled out of the swim wheezing, fit
in both. Jane, competing in the 60–64 age bracket
to burst but once out I recovered and the organisers
achieved a time of 33m51s in the criterium event (as
let me carry on. So I rode in the pouring rain and wind
well as the fastest lap time of all competitors, with
(watching the white lines carefully) and then ran 5 km
3m36s), and also won gold in the cycling road race
up and down lots of hills! I was really pleased to be
with a time of 53m11s, covering 27 km while battling an
able to continue as generally in triathlon, once out of
“horrific” headwind. Jane added she is proud to “claim
a discipline – that’s it. No medals for me – but I didn’t
an international field” in the criterium race by beating
go expecting any as I knew all the competitors. BUT
two Australians and a Scot.
we had so much fun. The atmosphere at the whole
ENT Dr Chris Seeley, who frequently competes in games was just great.”
triathlons and half-marathons, was aiming for a time
Medical Outreach Team CNS Sue Cooper
under 2 hours 30 minutes as he tackled a triathlon of
competed in the 50 m freestyle swim just four years
1500 m swim, 40 km bike ride, and 10 km run in his
after she first learned to swim. “Someone famous once
60–64 age bracket. Chris achieved a silver medal and
said ‘Nothing is impossible to the willing mind’. I use
finished just behind Dr John (Johan) Hellemans, one
this phrase often on my grandsons, so thought I better
of the top triathletes in the country. Chris, who trained
get sorted, learn to dive without my goggles falling off
up to twice daily for 4–5 months leading up to the
and swim a bit faster!” Sue said. “I managed to swim
event, achieved the phenomenal time of 2.15.24, just
50m freestyle in the 60–64 age group in 55.8 sec,
87 seconds behind Hellemans.
which was a personal best for me, and still breathe!
healthAlliance business analyst Chris Budge and As my young grandson said, “‘Nana, you came 31st
her fours partners won gold in the lawn bowls Women’s in 50 m Freestyle for 60–64 year olds in the WORLD!’
Fours category for 50–59-year-olds after two rounds I can live with that.”
of elimination.
Two Northland DHB staff were part of the NZ 45+
Women’s Field Hockey team which won gold at the
Games. They are Clinical Nurse Specialist for Medical
Outreach Alma Quirey and Estelle Lang, clinical
pharmacist. Both also played for the Northern Ferns
45+ women’s hockey team at the Games. Alma, Estelle
and their teammates had been training for this event
since October 2016. Alma has been playing hockey
since she was 9 years old and Estelle since she was
13. The Northern Ferns came home silver medallists
and plan to play in the next World Masters Games
which will be hosted in Japan in 2021. Alma and Estelle
played in the final of the Games then returned home
to go into camp the next day for their New Zealand
teams after having already played six games for the
Northern Ferns. Medical Outreach Team Clinical Nurse Specialist Sue Cooper
Communication 15Ron Thanks 100 Donors For
Keeping Him Alive
Each day Ron Pattenden says a prayer thanking the A Whangarei local, Ron was found to be anaemic
100 blood donors who have kept him alive. If he didn’t when increasingly low oxygen levels meant he could
receive 1-2 units of blood from donors each week, barely move, let alone play bowls. Further testing, an
Ron might not have been here to share his story unsuccessful course of Eprex and a bone marrow biopsy
around World Blood Donor Day, Wednesday June 14. found his marrow wasn’t producing healthy blood and
leukaemia was detected after that.
Ron suffers from asbestos disease, kidney failure, and
diabetes on top of LGL leukaemia and anaemia, and also
had his thyroid gland removed decades ago, so each
condition causes complications – for example, the iron
levels in each unit of blood Ron takes in must be watched
carefully as his failing kidneys can’t process much iron.
A normal healthy adult will have haemoglobin levels of
120-170 grams per litre of blood (g/L); Ron typically has
just half that, often with levels of around 86g/L. Each
unit of blood Ron receives raises his haemoglobin by
ten grams. At its lowest point, around 2014, Ron had a
haemoglobin level of 57 and struggled to breathe.
The O-type blood Ron receives gets processed all over
the country. Donors are anonymous, but Ron and wife
Rosalie always appreciate the people who have taken
time out of their day to volunteer part of themselves.
“We tell our children and grandsons, go and give blood
for god’s sake!” Rosalie says.
Ron with nurse Les.
Ron, 76, has large granular lymphocytic leukaemia “Years ago I used to be worried about blood transfusions,
(LGL leukaemia), a rare blood cancer. Ron also suffers where the blood came from,” Ron reflects, “But I’ve
anaemia, meaning the haemoglobin in his red blood cells become aware it is very much screened by the blood
is low and his blood struggles to carry a healthy level of service. I absolutely admire the donors. Not a day goes
oxygen so he needs an input of fresh blood each week. by I don’t get out of bed and say Thank God for the blood
donors.”
Roughly two thirds of donated blood goes to people
requiring transfusions for medical conditions such as
anaemia, cancer and blood disease. 29 percent of
donated blood goes to cancer patients. Around a quarter of
blood supplies are used in surgery, including cardiac and
emergency surgery. The other six percent of donations is
used to treat blood loss after childbirth.
120,000 units of blood are collected in NZ each year,
treating an estimated 29,000 patients. After it has been
processed, nearly 40 percent of blood is used in hospitals
around Auckland; just 2.75 percent of processed blood
is consumed from Whangarei Hospital's Blood Bank.
470mls is the average amount of blood donated. This is
7-8 percent of the blood in an average adult, and each
donation is separated into red blood cells, platelets, blood
clotting factors, plasma, anti-D, immunoglobin, globulins
and several pharmaceutical/medicinal components. Ron’s
severely low haemoglobin means he needs to receive
anywhere from 280-313mls of red blood cells at a time.
That comes from one unit of blood from one donor, and on
weeks when Ron’s haemoglobin is critically low, he needs
two units. Having had 85 transfusions in his life, receiving
1-2 units at a time from 1-2 donors, Ron estimates he has
100 donors to thank.
16 ExcellenceMidwives Matter
International Day of the Midwife Joy’s joyous handmade midwife cards
International Day of the Midwife was observed on Friday Core midwife Joy Leslie this year made dozens of cards
May 5. The day was organised by the International which parents filled in at Te Puawai Ora and the Baby,
Confederation of Midwives, supported by the NZ College Bump and Toddler Expo, so that midwives could receive
of Midwives and was about highlighting the important role a personalised message from whānau they have worked
the country's 3000 midwives play in the health of mothers with and know they were not forgotten.
and children, as well as family planning. This year's
“It’s because I appreciate being a midwife and love my
International Day of the Midwife theme was 'Midwives,
job,” Joy said, thanking fellow midwife Charlotte Avery for
Mothers and Families: Partners for Life.
the suggestion to make the cards. Many of the cards were
Northland DHB clinical midwife manager Yvonne Morgan filled out by appreciative whānau well ahead of Midwives
said the theme captured the professional friendship Day. The plan was to photocopy the cards and share
around childbirth. “The woman should be in the middle these with the Ministry of Health as a demonstration of
of a decision-making partnership between her, her how much midwives are valued.
consultant obstetrician and the midwife.” Whangarei
The cards have another purpose, too – it is hoped that
Hospital’s Te Kotuku Maternity Unit is the location of the
messages around Midwives Day would reach the small
largest number of births in Northland every year. Last
number of mums who give birth without a midwife. While
year there was an average of 141 births per month at
every woman presenting at hospital without a midwife
Whangarei, an increase on the year before of 123 per
is assigned one by the maternity ward, Joy says there
month. It all means an average of 4–5 births per day
are still occasionally women turning up in labour without
at Te Kotuku alone. There are almost 100 midwives in
a midwife organised. “I want women who don’t access
Northland – around 50 are self-employed, Whangarei
antenatal care to realise the value of midwifery,” Joy said,
Hospital has 31 core staff midwives, 3 in the community,
“Because we need midwives to give our women a good,
then there are 8 midwives in Bay of Islands Hospital, 2
healthy pregnancy – otherwise poorly developed babies
at Kaitaia and one at Dargaville.
can result.”
People First 17You can also read
